patrick.net

Back in January I wrote an article about four randomized controlled trials of ivermectin as a treatment for covid-19 that had at that time released their results to the public. Each of those four trials had promising results, but each was also too small individually to show any meaningful impact on the hard outcomes we really care about, like death. When I meta-analyzed them together however, the results suddenly appeared very impressive. Here’s what that meta-analysis looked like:



It showed a massive 78% reduction in mortality in patients treated with covid-19. Mortality is the hardest of hard end points, which means it’s the hardest for researchers to manipulate and therefore the least open to bias. Either someone’s dead, or they’re alive. End of story.

You would have thought that this strong overall signal of benefit in the midst of a pandemic would have mobilized the powers that be to arrange multiple large randomized trials to confirm these results as quickly as possible, and that the major medical journals would be falling over each other to be the first to publish these studies.

That hasn’t happened.

Rather the opposite, in fact. South Africa has even gone so far as to ban doctors from using ivermectin on covid-19 patients. And as far as I can tell, most of the discussion about ivermectin in mainstream media (and in the medical press) has centred not around its relative merits, but more around how its proponents are clearly deluded tin foil hat wearing crazies who are using social media to manipulate the masses.

In spite of this, trial results have continued to appear. That means we should now be able to conclude with even greater certainty whether or not ivermectin is effective against covid-19. Since there are so many of these trials popping up now, I’ve decided to limit the discussion here only to the ones I’ve been able to find that had at least 150 participants, and that compared ivermectin to placebo (although I’ll add even the smaller trials I’ve found in to the updated meta-analysis at the end).

As before, it appears that rich western countries have very little interest in studying ivermectin as a treatment for covid. The three new trials that had at least 150 participants and compared ivermectin with placebo were conducted in Colombia, Iran, and Argentina. We’ll go through each in turn. ...

What we see is a 62% reduction in the relative risk of dying among covid patients treated with ivermectin. That would mean that ivermectin prevents roughly three out of five covid deaths. The reduction is statistically significant (p-value 0,004). In other words, the weight of evidence supporting ivermectin continues to pile up. It is now far stronger than the evidence that led to widespred use of remdesivir earlier in the pandemic, and the effect is much larger and more important (remdesivir was only ever shown to marginally decrease length of hospital stay, it was never shown to have any effect on risk of dying).

I understand why pharmaceutical companies don’t like ivermectin. It’s a cheap generic drug. Even Merck, the company that invented ivermectin, is doing it’s best to destroy the drug’s reputation at the moment. This can only be explained by the fact that Merck is currently developing two expensive new covid drugs, and doesn’t want an off-patent drug, which it can no longer make any profit from, competing with them.

The only reason I can think to understand why the broader medical establishment, however, is still so anti-ivermectin is that these studies have all been done outside the rich west. Apparently doctors and scientists outside North America and Western Europe can’t be trusted, unless they’re saying things that are in line with our pre-conceived notions.